Infertility Medication

Medications to treat infertility can be used alone or along with assisted reproductive technologies, such as in vitro fertilization (IVF).

There are many approaches used to treat female infertility. Medications are often used alone, particularly for women who have medical conditions that cause infertility. They may also be used along with assisted reproductive technologies (such as in vitro fertilization).

Medications for Ovarian Stimulation

Women are born with their lifetime supply of eggs within the ovaries. During each monthly menstrual cycle, eggs develop within the ovarian follicles under the influence of the follicle stimulating hormone (FSH). Once the egg matures, ovulation is triggered by the luteinizing hormone (LH).

Several fertility drugs, such as clomiphene, indirectly induce ovulation. Other fertility drugs, called gonadotropins, directly stimulate the ovaries.

Clomiphene

Clomiphene (Clomid©) has been used for years to induce ovulation in many women who have irregular or absent periods.

Clomid works at an area of the brain called the hypothalamus. The hypothalamus is responsible for regulating the production of follicle stimulating (FSH) and luteinizing hormones (LH). The hypothalamus produces gonadotropin releasing hormone (GnRH) which signals the pituitary gland to increase its production of FSH and LH. FSH stimulates the development of eggs within the ovarian follicles on the ovaries.

Gonadotropins

Medications called gonadotropins are used to directly stimulate the ovaries to produce multiple eggs. These drugs contain either the hormones FSH and LH (Repronex), or FSH alone (Follistim, Gonal-F, Bravelle).

These injectable fertility drugs are used in assisted reproductive technology cycles and stimulated intrauterine insemination (IUI) and cause the development of numerous eggs.

FSH is also very effective in treating women who have certain disorders such as hypothalamic amenorrhea.

Medications for Egg Maturation

Human chorionic gonadotropin (hCG) is given to induce ovulation (i.e. cause egg release). The body recognizes hCG as LH which normally triggers ovulation.

During IVF, hCG is administered 36 to 38 hours prior to egg retrieval.

Medications to Prevent Premature Ovulation

When gonadotropins are used in IVF cycles, products such as Lupron or Antagon are given to precisely control hormone levels and time ovulation. This allows for greater control over the IVF cycle.

Lupron (leuprolide acetate) was originally introduced for the treatment of endometriosis. Ovulation cannot occur while taking Lupron unless an injection of hCG is given. This is extremely important since ovulation must be carefully timed with egg retrieval or the IVF cycle could be “lost."

Antagon (ganirelix acetate) produces the same biologic effects as Lupron by a different mechanism. Antagon blocks the action of GnRH at the pituitary gland and causes a much quicker and complete suppression of GnRH levels. This leads to an effective blocking of the LH surge, thereby preventing the premature release of the eggs.

We prefer Antagon due to fewer injections, less FSH, and a much simpler protocol.

Medications for Luteal Phase Support

Progesterone is a hormone that stimulates and supports the development of the endometrium, the tissue lining the uterus. Progesterone is initially produced by the ovary after ovulation. Elevated progesterone levels are one indication that ovulation has occurred.

The endometrium must thicken and become more vascular during the luteal phase of the menstrual cycle in order to accept and support the developing embryo. Both estrogen and progesterone stimulate the development of the endometrium.

After conception, progesterone is secreted by the placenta and is necessary to maintaining an ongoing pregnancy. Progesterone is sometimes administered to women with recurrent miscarriage and it is usually given to women after assisted reproductive technology cycles, such as IVF.

Other Medications

Many other types of medications are used to treat the various conditions causing infertility.

Glucophage

Glucophage (metformin) is often used to induce ovulation in polycystic ovarian disease patients if the patient is insulin resistant.

Metformin reverses insulin resistance by sensitizing the cells to insulin thus lowering insulin levels, reducing androgen levels, and enabling ovulation.

If metformin alone is not effective, Clomid is often added.

Parlodel

Parlodel (bromocriptine) is used to treat a condition known as hyperprolactenemia, or elevated prolactin levels. Prolactin is the hormone responsible for breast milk production which normally rises during and after pregnancy.

Elevated levels in the absence of pregnancy can cause irregular ovulation and are often due to a benign tumor on the pituitary gland. The tumor is sometimes surgically removed depending upon its size and location or prolactin levels can be lowered using bromocriptine.

Antibiotics

Antibiotics are used to treat reproductive tract infections including chlamydia, gonorrhea, and others. The choice of antibiotic depends upon the seriousness of the infection and the suspected bacteria.

Corticosteroids

Corticosteroids are used in many different types of autoimmune disorders including lupus. They may also be used in cases where the adrenal glands cause overproduction of male hormones (androgens). We often use low dose corticosteroid therapy prior to embryo transfer to increase the chances of a successful implantation during IVF.

Providers

Reproductive Medicine Forms

Find information and consent forms for in vitro fertilization and related procedures, as well as medication protocol information.

Insurance

Insurance Accepted

This chart is a list of the most common health insurance plans we accept. This list is subject to change. Please check your individual plan to confirm their participation and the coverage allowed.

Due to the different physician groups and hospitals within the Wake Forest Baptist system, physician services and hospital services are billed separately. Please remember that health insurance coverage varies, so some services may not be covered.

If you don’t see your plan or you have questions, please call our Customer Service Center at 877-938-7497. We will do our best to work with you and your plan.

Key

WFUHS - Wake Forest University Health Sciences (professional services)
NCBH - North Carolina Baptist Hospital
LMC - Lexington Medical Center
CHC - Cornerstone Healthcare
Wilkes - Wilkes Regional Medical Center
HPR- High Point Regional
N/A - Not applicable to services provided at facility and/or CHC
NC -Not Contracted, very low to no volume for facility and/or CHC

Wake Forest Baptist Health Managed Care/MA Contracts - January2022

AETNA CONNECTED ACA/Exchange: Accepted at all locations

AETNA (PPO & HMO): Accepted at all locations

AETNA MEDICARE: Accepted at all locations

AETNA WHOLE HEALTH: Accepted at all locations

ALIGNMENT HEALTHCARE MEDICARE ADVANTAGE: Accepted at WFUHS, NCBH, Davie, LMC, CHC and Wilkes (not applicable to services provided at High Point)

AMBETTER OF NC: Accepted at all locations

AMERIHEALTH CARITAS NEXT ACA/Exchange: Accepted at all locations

APEX MEDICARE ADVANTAGE: Accepted at all locations

BCBSNC (PPO & HMO): Accepted at all locations

BCBS HIGH PERFORMANCE (NATIONAL NETWORK): Accepted at all locations

BLUE LOCAL WITH ATRIUM HEALTH: Accepted at all locations

BLUE MEDICARE: Accepted at all locations

BLUE VALUE: Accepted at all locations

CAROLINA BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH and CHC (not applicable to services provided at Davie, LMC, Wilkes and High Point)

CIGNA: Accepted at all locations

CIGNA BEHAVIORAL HEALTH: Accepted at NCBH and High Point (not applicable to services provided at Davie, LMC, CHC and Wilkes)

CIGNA HEALTHSPRING MEDICARE ADVANTAGE: Accepted at WFUHS, NCBH, Davie, LMC, CHC and High Point (not applicable to services provided at Wilkes)

CIGNA LIFESOURCE (TRANSPLANTS): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

COVENTRY/WELLPATH: Accepted at all locations

CRESCENT PPO (ASHEVILLE): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

DEVOTED HEALTH: Accepted at all locations

DIRECT NET: Accepted at WFUHS, NCBH, Davie, LMC, Wilkes and High Point (not contracted, very low to no volume for CHC)

FIRST HEALTH (COVENTRY): Accepted at all locations

FIRSTCAROLINACARE (PINEHURST, NC): Accepted at NCBH (not contracted, very low to no volume for WFUHS, Davie, LMC, CHC, Wilkes and High Point)

GATEWAY HEALTH ALLIANCE (VIRGINIA): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

GOLDEN RULE INS (UNITED): Accepted at all locations

HEALTHGRAM (formerly PRIMARY PHYSICIAN CARE): Accepted at WFUHS, NCBH and LMC (not contracted, very low to no volume for Davie, CHC, Wilkes and High Point)

HEALTHTEAM ADVANTAGE: Accepted at all locations

HUMANA CHOICECARE: Accepted at all locations

HUMANA MEDICARE ADVANTAGE: Accepted at all locations

LIBERTY ADVANTAGE (MEDICARE ADVANTAGE): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

MAGELLAN (BEHAVIORAL HEALTH): Accepted at WFUHS, NCBH and CHC (not applicable to services provided at Davie, LMC, Wilkes and High Point)

MEDCOST: Accepted at all locations

MEDCOST ULTRA: Accepted at WFUHS, NCBH, Davie, LMC, Wilkes and High Point (not applicable at CHC)

OPTUMHEALTH (TRANSPLANTS - APPLICABLE TO NCBH/WFUHS ONLY): Accepted at WFUHS and NCBH (not applicable to services provided at Davie, LMC, CHC, Wilkes and High Point)

PREFERRED CARE OF VA INC: Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

SOUTHERN HEALTH SVCS (COVENTRY-PPO ONLY): Accepted at WFUHS, NCBH, Davie and CHC (not contracted, very low to no volume for LMC, Wilkes and High Point)

TWIN COUNTY (VIRGINIA): Accepted at WFUHS and NCBH (not contracted, very low to no volume for Davie, LMC, CHC, Wilkes and High Point)

UNITED BEHAVIORAL HEALTH: Accepted at WFUHS, NCBH, CHC and High Point (not applicable to services provided at Davie, LMC and Wilkes)

UNITED BEHAVIORAL HEALTH INTENSIVE OUTPATIENT PROGRAM (WFUHS ONLY): Accepted at WFUHS (not applicable for services provided at NCBH, Davie, LMC, CHC, Wilkes and High Point)

UNITED HEALTHCARE: Accepted at all locations

UNITED HEALTHCARE ESSENTIALS ACA/EXCHANGE: Accepted at all locations

UNITED HEALTHCARE MEDICARE: Accepted at all locations

VA CCN: Accepted at all locations

WELLCARE: Accepted at all locations

WELLPATH (COVENTRY): Accepted at all locations

Key

WFUHS - Wake Forest University Health Sciences (professional services)
NCBH - North Carolina Baptist Hospital
LMC - Lexington Medical Center
CHC - Cornerstone Healthcare
Wilkes - Wilkes Regional Medical Center
HPR- High Point Regional
N/A - Not applicable to services provided at facility and/or CHC
NC - Not Contracted, very low to no volume for facility and/or CHC

Referring Physicians

At Atrium Health Wake Forest Baptist we understand the importance of referrals. Our Physician Liaisons partner with referring physicians in our community and beyond to provide information on our physicians and clinical services. Full list of new physicians.

Contact the Physician Liaisons